| NPI | 1407845563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX P1176) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: LA 15291R) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2024-08-08 |